Substance Education for Young Adults - PDF document

1 Portal - Substance Education for Youn
Portal - Substance Education for Young Adults (SEYA) This packet can be accessed online at : http://pfh.org/portal - seya/ Welcome to Portal ! We are excited that you have made the decision and commitment to participate in this innovative and effective education program! Our Mission “ Preferred Family Healthcare is a dynamic and caring organization committed to providing integrated care to assist individuals in achieving overall health and wellness .” Our P hilosophy In six simple wor ds our philosophy is that “ We Meet You Where You Are ” . Our Portal programs provide easy and immediate online access to treatment and/or educational services from anywhere. What You Will Need: All you need is a computer system and internet connection that meets the following requirements:  Windows 2000 or later; Mac OS X 10.4 or later.  Compatible web browser (Google Chrome or Firefox…both free to download).  Any standard 3d graphics card made in this millennium should work.  Avera ge - speed internet connectivity (e.g., Wi - Fi, cable, ethernet).  Web Camera – if not already on the computer; this can be purchased for around $40  High - Speed Internet Connection (1.5 Mbps or faster). Confidentiality We will respect your confidentiality and w e ask that you would do the same for others. In order fo r open disclosure to take place, participants must feel safe. What is said in a group session needs to remain in a group session. We encourage you to be honest. You have the added benefit of an Av atar in regards to confidentiality. Please do not share your real name or identifying information with other participants or ask others for this information. This will make it easier for you and others to share thoughts and feelings openly. We will prot ect your confidentiality as an alcohol and drug abuse treatment provider as governed by federal laws and regulations. Generally, the program may not say to a person outside the program that a consumer attends the program or disclose any information identif ying a participant in this program UNLESS: 1) Your or your legal guardian (if applicable) consents in writing 2) The disclosure is allowed by a court order; 3) The disclosure is made to medical personnel in a medical emergency; or 4) The disclosure is made to qualifie d personnel for research, audit, or program evaluation. Violation of Federal law and regulations by a program is a crime. Suspected violations may be reported to appropriate authorities in accordance with Federal regulations. Federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under State law to appropriate State or local authorities. Pertinent information about your case will be shared between treatment staff to help facilitate the treatme nt process. If you share in a group or with another staff member, the content of your disclosure may be important and helpful to your treatment staff. Sharing this information is not a violation of your confidentiality. Information shared is about progr ess, discharge, and any other information important to your case. Participant Feedback/Input Preferred Famil

2 y Healthcare strives to consistently imp
y Healthcare strives to consistently improve the quality of our programs. Your feedback is important to us. As a participant, you have the most direct experience with the services being provided therefore you have beneficial insight into the quality of the program. Many changes to programs have been made over the years as direct result of suggestions made by our participants, their families, and other agencies. We encourage you to provide input into programming activities by submitting suggestions via email to a staff member and by being honest on the Participant Satisfaction Survey completed at the close of treatment. In addition you will be re quired to complete three assessments (web based) upon admission, at discharge, and 3 - 6 months post discharge. What You Can Expect As you go through this program you can expect that you will be working with qualified professionals who understand the ful l continuum of alcohol and drug use from that one poor choice that led to an uncomfortable situation to more progressed use that may be impacting one’s school or job performance, family relationships, legal situations, and/or general functioning. Where yo u fall on this continuum is for you to decide and we will walk with you to assist you in this process. What you get out of this program is highly dependent on what you put into this process. You will be expected to complete homework assignments that may i nclude journaling that will be discussed during group and individual sessions . We encourage you to be honest in your assignments as no one but you will see this information. We will also provide you with access to additional information via links so that you can further learn, evaluate your use on your own, and/or connect with others who may serve as supports. We do ask for you to remain open - minded and patient with regard to other members in the groups. Participants will be entering this program talking about various issues as they explore their use of alcohol and or drugs ; please be reminded that we value an exploration and supportive stance no matter what issues are brought to group. We have found this approach to be highly effective. Listening to ot hers and sharing your thoughts are the keys to benefiting fully from this program. Successful Completion Participation in this program is a c ommitment and not one to take lightly , as full attendance and participation is key to obtaining a successful comple tion. Prior to s ucces sfully completing this program , you will have attended and participated in all six sessions, all assignments will be completed and discussed and you will have completed all follow up assessments/surveys. Program Structure There are 6 sessions offered over a 6 week period. S essions will be approximately 1.0 hour in length. Prior to the initial session you will have received and signed all necessary admission paperwork, and read and understood this handbook. The curriculum is set up as such that you will be able to join a group at any place during the process. We do have the expectation of attendance and participation in every session; we will be unable to give credit for attendance in classes if you do not attend the full class. Att endance wil

3 l be monitored through video conferencin
l be monitored through video conferencing. Homework Assignments may be given at the end of each session to be completed for discussion by the next session. How do I get started? Attached a t the back of this handbook will be a cop y of the Admission and Consent form. Once you have decided to participate in the program, you are expected to complete the Admission and Consent and take it with a photo ID to Preferred Family Healthcare at 3510 Frederick Avenue, St. Joseph, for them to fax or sc an to PFH - SEYA for enrollment the other copy is for you to keep . Below are payment options. Remember the entire payment must be received before programming will begin. The charge for the program is $ 80 , to be paid prior to beginning the program. Pa yment will not be refunded if you withdraw or fail to complete the program. Payment should occur by going to PFH.org, and then Help & Support, and then Pay Online , for the description drop down indicate this is Portal SEYA . The client number you will ent er will be 999657 . Or you may mail a money order to Preferred Family Healthcare, c/o Portal SEYA , 900 E. LaHarpe Street, Kirksville, MO 63501. After payment is made you will need to email Portal seya@pfh.org stati ng your interest in starting the program . Per regulatory requirements, a copy of the independent audit report of Preferred Family Healthcare, Inc. is available for review upon request. Skype Tutorial As a way to help monitor your participation in each g roup of the program, PFH uses audio/video conference software so we can see your face and verify your identity. This program is free to install. Prior to your first group session, you wil l need to setup a Skype account. To install Skype, go to www.skype.com/go/downloading/ and SkypeSetup.exe will automatically download. Click SkypeSetup.exe and install the program, following the prompts. You will be walked through setting up your free Skype account as part of the installation. If you have any problems or confusion with installing or using Skype, visit http://www.skype.com/intl/en - us/support/user - guides/ for support. You will be promp ted, during the Skype installation/setup process, to set your profile picture. Skype will use your webcam to take a picture of your face. PFH requires a clear picture of your face for identity. You can add/change a profile picture at any time by opening Skype, then clicking “Skype”, scroll to “Profile”, and then click “Change your picture”. A new window will appear and click “Take Video Snapshot” at the top right corner. Then follow t he directions to save the snapshot. You are required to keep Skype open during any group or individual session with PFH so that your identity can be verified instantly. Have your speakers turned up enough to hear Skype ring when the facilitator calls your Skype accoun t, you will be prompted to answer the call (the softwa re is user friendly and will let you know when someone is calling). The facilitator may Skype you at any time during groups. If you have any additional questions that could not be answered by online Skype Support (link above), you may contact PFH staff at portal seya @ pfh.org Ad

4 ditional Resources PFH Home Page:
ditional Resources PFH Home Page: http://www.pfh.org/ PFH Contact for Email Feedback: portal seya @pfh.org Nati onal Treatment Locator: http://www.samhsa.gov/treatment/index.aspx Do I have a Drinking Problem ? http://www.alcoholscreening.org/Home.aspx ADMISSION AND CONSENT – Portal SEYA PLEASE PRINT LEGIBLY Client Name: _______________________________________________ Phone: _____________________________ Address: ______________________________ City: _____________________ State: ___________ Zip: _________ Email: _________________________________@__________________________ Date of Birth: _____/_____/_____ Emergency Contact: _______________________________________________ Phone: _________________________ Signing this form gives permission to PFH to contact the Emergency Contact in the Event of an Emergency disclosing information specific to the Emergency Event. Referral Source (if applicable) : ____________________________________________ Phone: _________________________ Signing this form gives permi ssion to PFH to disclose information in writing and/or verbally specific to attendance, participation, and completion of trea tment. Attorney (if applicable) : _ _______________________________________________ _ Phone : _________________________ Signing this fo rm gives permission to PFH to disclose information in writing and/or verbally specific to attendance, participation, and comp letion of treatment. Court: __ St. Joseph Municipal Court ___________________________________ Phone : _____ 816 - 271 - 468 6 _________ S igning this form gives permission to PFH to disclose information in writing and/or verbally specific to attendance, participa tion, and completion of treatment. I, __________________________________________, am voluntarily participating in the Portal SEYA p rogram and have a clear understanding of program expectations through reading the Program Manual, which includes information on the Notice of Privacy Practices. I understand that attendance and participation are keys to obtaining a successful completion . I agree to participate in baseline and follow - up surveys during , and upon completion of, the educational program . I also give consent to release my personal identif ication & contact information to Missouri Institute of Mental Health (MIMH) . I also give MIMH permission to contact me (via email) regarding surveys, and allow them to report related data to Preferred Family Healthcare . I understand that it is my responsibility to access necessary technological equipment listed below in order to participate in services offered in this program , and by signing below I am acknowledging that I have this equipment a vailabl e to me or that I have made arrangements to obtain access through a location provided ( please find attached to this packet a resource guide listin g where to access equipment to participate in the program if you do not have your own access) .  Windows 2000 or later; Mac OS X 10.4 or later.  Compatible w eb browser (Google Chrome or Firefox…both free to download ).  Any standard 3d graphics card made in th is millennium should work.  Average - speed internet connectivity (e.g., wif

5 i, cable, ethernet).  Web Cam â€
i, cable, ethernet).  Web Cam – if not on the computer; this can be purchased for around $40 - $60 I understand my records are protected under the federal regulations governing Confiden tiality of Alcohol and Drug Abuse Client Records, 42 CFR Part 2, and HIPAA, and cannot be disclosed without my written consent unless otherwise provided for in the regulations. I also understand that the above consent is subject to revocation by me at any time, except to the extent an action has been taken in reliance on this consent. This consent will stay in effect until account is settled. By signing below, I acknowledge that I am aware and in agreement with assuming full financial responsibility for t he services I receive in the amount of a one - time $ 80 payment, to be paid prior to beginning the program. I understand that this will not be refunded to me should I withdraw or fail to complete the program. Payment should occur by going to https://pfh.org/payonline/ or PFH.org, then clicking on “Help and Support . The client number you will enter will be 999657 . Or you may mail a money order to Preferred Family Healthcare, c/o Portal SEYA , 900 E. LaHarpe Street, Kirksville, MO 63501. After payment is made you will need to email Portal seya @pfh.org stating your interest in starting the program. Client Signature: _____________________________________________________ Dat e: _______________________ You may and are encouraged to utilize your own equipment or equipment that you have familiar and comfortable with to access Portal Substance Education for Young Adults (SEYA). However if you do not have equipment available to you, below are sites within in your community that you can access the equipment needed. Please note that these are community resources not necessarily involved in or knowledgeable about your requirements or the Portal – SEYA program.  If you would like to use a library location to access your Substance Education for Young Adults class you must contact Mary Beth Revels to reserve your computer for your class time at least 48 hours prior to the first class. Her phone number is 816 - 232 - 4038. Downtown Librar y 927 Felix Street St. Joseph, MO Hours: Monday, Tuesday & Wednesday: 9:00 am to 8:00 pm Thursday: 9:00 am to 6:00 pm Friday & Saturday: 9:00 am to 5:00 pm East Hills Library 502 N. Woodbine Road St. Joseph, MO 64506 Hours: Sunday: 11:00 am to 3:00 pm Mo nday, Tuesday, Wednesday & Thursday: 9:00 am to 9:00 pm Friday & Saturday: 9:00 am to 5:00 pm Carnegie Library 316 Massachusetts Street St. Joseph, MO 64504 Hours: Monday: 1:00 pm to 5:00 pm Tuesday & Thursday: 11:00 am to 7:00 pm Wednesday, Friday & Sat urday: 10:00 am to 6:00 pm Washington Park Library 1821 N. Third Street St. Joseph, MO 64505 Hours: Monday, Wednesday & Friday: 9:00 am to 5:00 pm Tuesday & Thursday: 12:00 noon to 8:00 pm Saturday 1:00 pm to 5:00 pm  If you would like to access Portal SE YA from PFH, it would be beneficial to make contact to let them know you will be arriving. Phone number 816 - 364 - 6007 Preferred Family Healthcare 3510 Frederick Avenue St. Joseph, MO 64506; Hours: Monday – Friday: 8:00pm to 6:00p